title: Risk factors for the development of reexpansion pulmonary edema in patients with spontaneous pneumothorax.
abstract: BACKGROUND
  Reexpansion pulmonary edema (REPE) is known as a rare and fatal complication after tube thoracostomy.
  
  
  OBJECTIVE
  We investigated the risk factors for the development of REPE in patients with spontaneous pneumothorax.
  
  
  METHODS
  We selected patients who were diagnosed with spontaneous pneumothorax and were initially treated with tube thoracostomy between August 1, 2003 and December 31, 2011. The patients' electronic medical records, including operative notes and chest x-ray and computed tomography scans, were reviewed.
  
  
  RESULTS
  REPE developed in 49 of the 306 patients (16.0%). REPE was more common in patients with diabetes (14.3% vs 3.9%, P=0.004) or tension pneumothorax (46.8% vs 16.2%, P=0.000). The pneumothorax was larger in patients with REPE than without REPE (57.0±16.0% vs 34.2±17.6%, P=0.000), and the incidence of REPE increased with the size of pneumothorax. On multivariate analysis, diabetes mellitus [(odds ratio (OR)=9.93, P=0.003), and the size of pneumothorax (OR=1.07, P=0.000) were independent risk factors of REPE.
  
  
  CONCLUSIONS
  The presence of diabetes increases the risk of REPE development in patients with spontaneous pneumothorax. The risk of REPE also increases significantly with the size of pneumothorax.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Gyeonggi-do, South Korea.
authors.forename: Jeong-Seob
authors.initials: JS
authors.lastname: Yoon
authors.forename: Jong-Hui
authors.initials: JH
authors.lastname: Suh
authors.forename: Si Young
authors.initials: SY
authors.lastname: Choi
authors.forename: Jong Bum
authors.initials: JB
authors.lastname: Kwon
authors.forename: Bae Young
authors.initials: BY
authors.lastname: Lee
authors.forename: Sang Haak
authors.initials: SH
authors.lastname: Lee
authors.forename: Chi Kyung
authors.initials: CK
authors.lastname: Kim
authors.forename: Chan Beom
authors.initials: CB
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000150:complications* / Q000601:surgery*; D011654:Pulmonary Edema / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology*; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013907:Thoracostomy / Q000009:adverse effects; D014057:Tomography, X-Ray Computed